Association between residents’ work hours and patient care ownership: a nationwide cross-sectional study in Japan

Abstract

Abstract Purpose In the current era of physician work-hour regulations, patient care ownership (PCO) has received considerable attention. The aim of the study was to investigate the association between working hours and PCO. Methods This was a nationwide cross-sectional study. The study recruited residents who completed the General Medicine In-Training Examination. The primary outcome was PCO, assessed using the Japanese version of the PCO Scale (J-PCOS). The secondary outcomes were the four dimensions of the J-PCOS (i.e., assertiveness, sense of ownership, diligence, and being the “go-to” person). The explanatory variable was weekly working hours. We examined the association using multivariable linear regression analysis. Results 1836 participants were included in the analysis. After adjustment for possible confounders, residents working ≥ 70 to < 90 h/week had greater PCO than those working ≥ 60 to < 70 h/week. Working ≥ 70 to < 90 h/week was also associated with assertiveness and being the “go-to” person. No clear trend was seen in the relationship between working hours and sense of ownership or diligence. Conclusion While determining appropriate resident work hours requires comprehensive consideration of a number of factors, in terms of PCO training, the working hours of 80–90 h/week may be an option.

Keywords

• Professionalism
• Workplace conditions
• Patient care
• Internship and residency